Limited Health Literacy is a Barrier to Medication Reconciliation in Ambulatory Care
Limited health literacy may influence patients’ ability to identify medications taken; a serious concern for ambulatory safety and quality.
To assess the relationship between health literacy, patient recall of antihypertensive medications, and reconciliation between patient self-report and the medical record.
In-person interviews, literacy assessment, medical records abstraction.
Adults with hypertension at three community health centers.
We measured health literacy using the short-form Test of Functional Health Literacy in Adults. Patients were asked about the medications they took for blood pressure. Their responses were compared with the medical record.
Of 119 participants, 37 (31%) had inadequate health literacy. Patients with inadequate health literacy were less able to name any of their antihypertensive medications compared to those with adequate health literacy (40.5% vs 68.3%, p = 0.005). After adjusting for age and income, this difference remained (adjusted odds ratio [OR] = 2.9, 95% confidence interval [95%CI] = 1.3–6.7). Agreement between patient reported medications and the medical record was low: 64.9% of patients with inadequate and 37.8% with adequate literacy had no medications common to both lists.
Limited health literacy was associated with a greater number of unreconciled medications. Future studies should investigate how this may impact safety and hypertension control.